Image Wisely is a joint initiative of the American College of Radiology, Radiological Society of North America, American Society of Radiological Technologists and American Association of Physicists in Medicine.

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Nuclear Medicine

The 2009 National Council on Radiation Protection and Measurements, Report No. 160 — Ionizing Radiation Exposure of the Population of the United States — showed that medical exposure to patients is one of the largest sources of radiation exposure to Americans, nearly equaling the exposure from background sources. Nuclear medicine is the second largest source of medical radiation exposure after computed tomography.

The benefits of nuclear medicine procedures are immense and certainly exceed the risks. However, this is only true when they are ordered appropriately and studies are optimized to obtain the best image quality with the lowest radiation dose. Use the links below to find information and resources to optimize your nuclear medicine procedures. And be sure to take the pledge to image wisely!

Careful selection of patients to be imaged and the appropriate PET/CT imaging protocol should be a priority of the radiologist/nuclear medicine physician and the referring physician in order to avoid unnecessary repeated exposure.

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Calculating the actual radiation exposure for an individual patient is complex and multifactorial, open to uncertainty and not routinely done in the clinical setting. Nonetheless, the simplest approach to reduce patient radiation exposure is three-fold.

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Discussing the evaluation of radiation dosimetry for nuclear medicine.

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Myocardial perfusion imaging has evolved from planar scintigraphy to our present state of multiple-detector SPECT imaging.

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There has been a recent emphasis on patient-centered imaging, whereby SPECT imaging protocols are tailored to specific patient needs and diagnostic expectations.

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Changing one parameter in a nuclear medicine procedure will affect all others. It is critical to understand all of the changes that occur when modifying a single parameter.

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Although most SPECT imaging protocols have been optimized over time, it is worthwhile to be aware of aspects that can affect patient dose and image quality.

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Myocardial perfusion positron emission tomography (PET) using 82Rb or 13N ammonia is an accurate method to evaluate rest and stress myocardial perfusion, to detect significant coronary artery disease, and to risk-stratify patients with regard to cardiac event-free survival.

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Image Wisely encourages practitioners to optimize the amount of radiation used in
medically necessary imaging studies and to eliminate unnecessary procedures

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